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Low-Income Families Hit Harder by High Deductibles

TUESDAY, Nov. 23 (HealthDay News) -- Low-income American families with high-deductible health plans are more likely to delay or forgo medical care due to cost than high-income families with similar coverage, a new study finds.

Researchers surveyed 141 low-income families (household incomes less than 300 percent of the federal poverty level) and 273 higher-income families who had high-deductible health plans in 2009.

Overall, low-income families were more likely than higher-income families to say they had delayed or not sought care because of the cost (57 percent versus 42 percent, respectively). This included care for an adult (51.1 percent versus 34.8 percent), care for a child (24.1 percent versus 13.9 percent) and operations or procedures (19.8 percent versus 6 percent).

"Respondents from lower-income families were no more likely than those from higher-income families to find their health plan difficult to understand, or feel their family was not well protected from out-of-pocket health care expenses," wrote Dr. Jeffrey T. Kullgren, a Robert Wood Johnson Foundation Clinical Scholar, Philadelphia VA Medical Center, the University of Pennsylvania, Philadelphia, and colleagues. "In addition, respondents from lower-income families were no less likely than respondents from higher-income families to report having tried to find out in advance whether they would have to pay for a specific service before meeting their deductible limit, or how much they would have to pay for a service since joining their health plan."

The study appears in the Nov. 22 issue of the Archives of Internal Medicine.

"These findings suggest that physicians have a central role to play in helping their patients navigate the challenges of decision-making in high-deductible health plans," the study authors concluded.

"Beyond the implications for clinicians, our findings have important implications for federal health reform," they concluded. "Reform legislation that establishes an individual health insurance mandate could lead more families to enroll in plans with high levels of cost-sharing, as has been seen following the implementation of coverage mandates in Massachusetts. If more families do enroll in high-deductible health plans, policymakers should consider strategies to support patients facing high levels of cost-sharing."

More information

The U.S. Agency for Healthcare Research and Quality has more about health insurance.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, Nov. 22, 2010

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